The use of new antigens in the complement-fixation test for acute poliomyelitis

Abstract

A complement-fixation test for acute poliomyelitis using unheated antigens derived from suckling mouse brain infected with poliovirus Type 1 or Type 2 is described.The results of tests in 62 patients clinically diagnosed as cases of acute poliomyelitis in a recent epidemic and in 26 controls are recorded.The CF tests were positive in 100% of 53 cases with poliovirus Type 1 and/or Type 2 in stool. A positive result was obtained in 23 (76%) of 30 cases whose sera were examined in the first 7 days of illness.Negative tests of the initial serum samples were found in 15 (28·5%) of 53 cases, but all these became positive in titres of 40 or 80 on testing of convalescent serum.In 31 (69%) of 45 cases whose sera were re-tested between the 3rd and 4th weeks of illness the CF antibody levels rose, reaching titres of 80 or 160 in most instances. Of the remaining 14 cases only one dropped in insignificant degree (from titre 320 to 160) and the 13 stationary results had been positive in titres of 40–160 on initial tests most of which were performed in the 2nd week of illness.Homotypic CF antibody response without crossing was found in 37 (71%) of 52 cases with Type 1 or Type 2 virus in stool. In the cases of crossing the heterotypic antibody response was either transient, diminishing or stationary in all and in only low titre in most instances.In 26 control cases there were seven positive CF tests, but one of these was nonspecific, five were in lowest titres, and one case appeared to have had recent poliomyelitis infection.Heating the antigens did not broaden the reaction. It caused only slight loss of potency except in two cases in which the CF titre increased substantially.The antigenic preparation described appears to be superior to antigens of other origin in the diagnosis of acute poliomyelitis by complement-fixation tests, as positive tests are recognized earlier in the illness and the titres are higher. Homotypic results were obtained in all cases and no instance of false negative occurred in this series.I would like to thank the medical staff of the Cape Town City Hospital for Infectious Diseases for the trouble taken in collecting stools and paired sera, and Prof. Kipps for his interest in this work. I am indebted to Miss Karin Larssen for valuable technical assistance.